Blindsided by the Obvious: Figuring Out Insurance Under Obama
I really wasn't too concerned about Obamacare personally. I have a good job, with decent — if not great — benefits, and while I was worried about the effect the ill-advised law would have on the nation as a whole, I figured I'd get to keep my insurance.
I was further convinced I didn't need to worry about it when I got an email from my regional manager telling us that corporate had passed a miracle and we'd not be seeing a premium increase.
I fell for that one hook, line, and sinker.
Imagine my dismay when they finally started open enrollment and I discovered my plan — which I was not fond of, but which was at least affordable — had been eliminated.
We'd originally had three separate plans: a premium plan with superb bennies; a middle plan, which was not as comprehensive but was still pretty good; and a low-cost plan which, while not great, still provided decent coverage at a price I could sort of afford.
That, thanks to Obama, Kathleen Sebelius, Harry Reid, and Nancy Pelosi, has now been reduced to two plans — a premium plan and a high-deductible plan.
The high-deductible plan now runs the same $181.93 per paycheck I'd been paying to this point. Not cheap but at least affordable.
Except it has no prescription drug benefit. You pay the "negotiated rate."
This is a problem since my wife has rheumatoid arthritis, serious asthma, and is pre-diabetic. She takes four or five pills a day, more on weekends because some of them are once a week.
Then there's me. My health problems are not as serious, but I'm a chronic insomniac who needs meds to sleep, I have back problems and carpal tunnel syndrome (journalist, occupational hazard), and I have a few pills a night to take as well. We need that prescription benefit.
No joy if we go with the cheap plan. But I figure I can live with that if the rest of the plan is good.
Not so much.
Doctor copay? Nope. The plan will pay 60% of the doctor visit after the deductible. Hospitalizations (a serious consideration with my wife's health issues)? After deductible. Emergency room visits? After deductible.
All of it after the $9,000 deductible.
So I look into the premium plan.
Well, there's a $20 copay for doctor visits, a prescription benefit, and the deductible is a third what the cheap plan has, but ER visits, which were $100 under my old plan, are now $250 under the premium plan.
Dental and vision benefits haven't changed, but even the premium plan isn't as good as what was previously available. Total cost? Exactly $373.93 per paycheck — more than double what I was paying — and I had just 10 days to figure out what I was going to do.
Off to the exchange, where even a bronze plan, which is worse than the high-deductible plan I was being offered, was over $400 per month — and since a qualifying plan is available through my employer, I'm not eligible for a subsidy.
Well, given my wife's health issues, and adding in her family history of cancer making it likely we'll be facing that at some point, I had to go for the premium plan. Now, because it's pre-tax I won't see an additional $192 coming out of my check, but it is going down by just over $150 a month after the first of the year. And, like most people, we're struggling now.
So much for "if you like your plan you can keep your plan." I didn't particularly like my plan, but it covered what I needed and I could afford it. This? Not so much.
I have talked to a lot of people in the medical field and they all hate this. Indeed, doctors over 50 are talking about retirement en masse. So much for "if you like your doctor you can keep your doctor."
What's astounding is the talking heads who are acting surprised by this, as conservatives have been warning about this for three years.
But, then, perhaps it's not so surprising. After all, I got blindsided by it, too.